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F01.52

Billable

Vascular dementia, unspecified severity, with psychotic disturbance

HCC Category Mapping

V28HCC 127Dementia, Mild or Unspecified
0.464
RxHCCHCC 112Dementia and Other Specified Brain Disorders
0.000

What This Code Means

Dementia caused by reduced blood flow to the brain, with psychotic symptoms such as delusions or hallucinations.

Coding Tips

  • Psychotic disturbance in dementia includes hallucinations, delusions, or other psychotic features
  • Ensure documentation distinguishes between primary psychotic disorder and psychotic symptoms secondary to dementia

Clinical Significance

Vascular dementia with psychotic disturbance indicates the presence of hallucinations, delusions, or paranoia in the context of cerebrovascular-caused cognitive decline. Psychotic symptoms in vascular dementia require careful pharmacologic management given the FDA black box warning on antipsychotics in dementia patients.

Documentation Requirements

  • Diagnosis of vascular dementia with cerebrovascular etiology
  • Specific psychotic symptoms documented (hallucinations — visual or auditory, delusions, paranoia)
  • Distinction from delirium-related psychosis (which is a separate condition)
  • Cognitive assessment results
  • Antipsychotic medication use with documented risk-benefit analysis
  • Safety assessment and monitoring plan

Commonly Confused Codes

Code Hierarchy

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